This day personally appeared before me a Justice of the Peace within and for the county of the subscriber who being duly sworn doeth depose and say that on the night of the sixth <​day​> of May 1842 while sitting in his dwelling in the town of in the county of , he was shot with intent to kill, and that his life was dispared of for severel days, and that he believes and has good reason to believe from evidince and information now in his possession, that Joseph Smith commonally called the Mormon prophet was accessary before the fact of the intended Murder; and that the said Joseph Smith is a citizen or resident of the State of and the said hereby applies to the of the State of to make a demand on the of the state of to deliver the said Joseph Smith commonally called the Mormon prophet to sone person authorized to receive and convey him to the and aforesaid, there to be delt with according to law

Sworn to and Subscribed before me this 20th day of July 1842